Why You Should Always Lay Your Sleeping Infant Down on His Back

There are reasons why it's important to follow specific guidelines when putting your infant who is less than 6 months old to bed. He needs to be lying down on his back, not on his tummy or his side. Doctors and experts have been saying this over and over again to avoid Sudden Infant Death Syndrome (SIDS).

As the name states, SIDS is the unexplained death of an otherwise healthy baby during sleep. It’s also known as “crib death” and mostly occurs between 1- to 4-months-old, explained Dr. Philip S. Chua, the chairman of cardiovascular surgery at Cebu Doctors' Hospital.

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SIDS is especially terrifying because medical experts and scientists still don't know why it happens. As to how it kills infants, Dr. Chua explained on the Cebu Doctor's University website, “Nobody knows for sure, but it appears that the baby is suddenly unable to breathe or stops breathing, resulting in respiratory arrest and ultimately cardiac arrest.” He added, “One can suspect that the upper airway somehow suddenly becomes blocked. Why? Science does not know.”

What we do know, however, is there are things parents can do to help prevent it. “Over the past several years, research has learned a very important lesson that can help reduce the risk of having SIDS — Keep the babies on their back when they sleep,” said Dr. Chua. This should be followed until the baby is 1 year old.

The American Academy of Pediatrics (AAP), who updated its recommendations for safe sleep in 2016, says that “the relationship between SIDS and sleep position is so strong, the Academy recommends that all infants be placed to sleep on their backs.” There are exceptions, of course, such as infants with health problems or birth defects that prevent them from lying down to sleep this way. Individual cases should be discussed by parents with a pediatrician.

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Based on a recent survey published in the journal Pediatrics, some parents worry that babies sleeping on their back are more likely to spit up and then choke. “There is no extra hazard from back-sleeping due to the anatomy of the airways,” explained Dr. Michael Goodstein, a neonatologist at York Hospital, to CBS News.

Some parents also felt their babies were more comfortable sleeping on their tummies. Dr. Chua set aside this old advice. “The old teaching was that the babies should sleep on their tummy. That advice was abandoned because of the observation that the prevalence of SIDS was very low among those babies who slept on their back, and higher among those who slept on their stomach.”

As WebMD points out, a baby placed on his side can roll over on his stomach. It's a position that "puts your baby’s face in the mattress or sleeping area, which can smother him."

"Once your baby can roll over both ways, which usually happens around 6 months, he may not stay on his back. That’s OK. It’s fine to let him choose his own sleep position once he knows how to roll over," WebMD adds.

In the same light, your baby does not need a pillow when he’s lying down on his back sleeping. Safe sleep guidelines recommend that keep your baby's sleeping space bare. It should only have a firm mattress and a tight-fitting bedsheet. Remove pillows, blankets, stuffed toys, bumper cribs and any other soft items. It is to help avoid SIDS, and accidental suffocation and strangulation.

Have your baby sleep in your room — not on your bed, but in his own crib — for at least 6 months, said the AAP guidelines. Breastfeeding is also recommended as it's associated with reduced risk for SIDS. Research shows that even breastfeeding for as little as two months can decrease a baby’s chance of SIDS.